Transcript Solution Focused CounSeling Building on What works

SOLUTION FOCUSED COUNSELING:
FOUNDATIONS AND APPLICATIONS
Michele Aluoch, PCC
River of Life Professional Counseling LLC
c.2014
Facts About Solution Focused Therapy
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Average length of sessions= 5-8 sessions for SFT
Average length of sessions for SFBT is 1-3 sessions
Max benefits of treatment are usually achieved win 68 sessions for 75% or more of patients.
Graduate students in research studies endorsed and
had the most successes with solution-focused
approaches compared to other treatment approaches:
saw real transformation and maintained changes in
clients, ease of use
Facts About Solution Focused Therapy
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With 80% of patients in a 2005 study having 4
sessions or fewer still 77% maintained symptom
reduction at 9 month follow up (Rothwell, N., 2005)
Why Do People Have Problems?
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They do things that don’t work.
They don’t have an expectation of change
Lack of insight/awareness
Not doing the right thing enough
Unwillingness to do something different
What Keeps People Stuck
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Don’t listen to anybody.
Listen to everybody.
Endlessly analyze and never change anything.
Blame others.
Blame yourself.
Keep doing what does not work.
What Keeps People Stuck
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Keep focusing on the same things when that does
not help.
Keep thinking the same thoughts that doesn’t help.
Keep putting yourself in unhelpful environments.
Keep relating to unhelpful people.
Basic Tenants of the Solution-Focused
Approach
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What works in spite of what doesn’t work
Looking for exceptions
Planning experiments and tests
There is some good even in bad or unpleasant
circumstances.
Nothing stays awful forever.
If you have done something that works one time before
you can do it again- twice, ten times, etc.
If you have done something for a small length of time
you can do it a little longer until it becomes a new
habit.
Basic Tenants of the Solution-Focused
Approach
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Clients want things to be different to where they
are not so problem bound.
Clients would not come to us if they did not believe
things could be better.
Clients are capable of self evaluating.
Clients are the experts on their own lives.
Treatment does not need to be scripted to be
successful and effective.
What Works in Spite Of What Doesn’t
Work
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Focus on client strengths
A success driven model
Solution building
Focus on the desired outcome
Uses success language: How have your managed?...
All clients have resource already.
What Works in Spite Of What Doesn’t
Work
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1) A 22 year married couple states that their marriage is on
the rocks again. When asked about their relationship
history they state that they connected right away when they
met and moved in a few days later. Since then they both
describe the relationships as “always intense-sometimes in a
good way, sometimes not.” Currently husband had been
having another affair (1 of many throughout the years) and
is living with this other woman because of frustrations in the
marriage. The wife expresses anger but also admits
throughout the last 22 years to having other men on the
side. They both admit that “no matter what we’ve done
through the years we always come back to each other.”
What Works in Spite Of What Doesn’t
Work
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2) A mother comes in stating that her daughter is
nothing but strong willed, defiant, and opinionated.
She wants her to be more happy and cooperative. She
wants her daughter to have treatment for behavior
issues.
3) A husband says his wife’s Bipolar “just plain gets to
him.” He comments, “can’t she just be more self
controlled and stop the mood swings?” He admits that
on the other hand he would not want to lose her passion
and enthusiasm as this is one of the things that drew him
to her.
What Works in Spite Of What Doesn’t
Work
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4) A family comes in stating that “no one ever agrees
on anything.” The presenting problem is that the house
has become increasingly chaotic all the time. The whole
family agrees that things are out of hand with how they
relate to each other. You ask if there was a time when
things were different. They state “before we moved
here. Life was consistent and predictable. We had the
schools, friends, and jobs we had for over 10 years.
This place is a world of difference and the only people
we know are each other.”
What Works in Spite Of What Doesn’t
Work
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5) A young adult is in trouble and is being referred
by his company for counseling. The referral states
that they are concerned that he is defensive, always
gives input even when not asked, likes to do things
his own way.” The client states that he “sees himself
as made for so much more than just this current job.”
What Works in Spite Of What Doesn’t
Work
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6) A young married coupe comes in after he had an
affair with the neighbor lady. They are young and only
married 5 years. Both state that “they have generally
been happy” until recently. They met in a small town up
north and their families knew each other from
childhood. Both consider themselves to have strong
values until this recent affair so they are shocked. They
were actively involved in community events and church
groups in the small town but haven’t really connected
with people in the city since moving here. They have
not found a church home in the last year so they are
staying away from services. They used to
What Works in Spite Of What Doesn’t
Work
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be involved in small town pot lucks and get togethers.
They state that they were never partiers but they only
way to get to know people in the current neighborhood
is to “drink and watch sports at the block parties.” Both
believe they let each other down by drinking and being
around people with different values than they normally
would. Both are desperate for friends and felt their
compromising led them to drinking, the parties, and the
husband’s affair. Both desire marriage reconciliation,
maintanence of values, and communication with the old
town 2 hours away in which they used to live.
What Works in Spite Of What Doesn’t
Work
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7) A teenager has a disability. She always dreamed of
being the athlete she was passionate about until her recent
injury which put here in a wheelchair, She swam, ran, and
played many seasonal sports until the day she was injured.
Docs told her that she probably will not regain full use of
her limbs except with exceptional therapy and practice.
She feels out of place, battles depression and feels as if
no peers really understand her. In one week she is to start
mentoring jr. high girls in an after school program
promoting self esteem called “You Can Do It.” She started
writing a book about hopes and dreams but is unsure if
she will finish it because she feels depressed, unattractive,
and like her life is over since the mobility problems.
What Works in Spite Of What Doesn’t
Work
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8) A man has tried to interview for job after job at his
company only to find out each time he is turned down, he
thinks deep down, “it’s all about who you know and who you
are willing to play up to.” A colleague recently told him of
a job he thinks this man is perfect for at a well know agency
around town. The first reaction of the client is, “I should not
even think about it because they probably have their cliques
too” but the friend continues sharing how smart, creative,
and relevant he believes the guy is for the job. With
apprehension and doubt the gentleman schedules an
interview not sure this job will come through either.
What Works in Spite Of What Doesn’t
Work
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9) Grief seems to be unending for a young man in his early
thirties. Matt buried 2 young children. Then one month ago
his wife had a miscarriage. Matt’s best friend was shot and
later died in the military. His mother recently let him know
that she has terminal cancer. People say that Matt “is a
strong person” but he admits to feeling weak. He is
uncertain he can handle more bad news. He attends a grief
support group in the community. Fellow members say that
he has encouraged them. He agrees that in many situations
he has been the “go to” person in life but is unsure he can
do this anymore or take on one more thing. He believes he
is at the end of his strength.
What Works in Spite Of What Doesn’t
Work
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10) Allison was molested throughout childhood by her foster
parents. Kids bullied her in school, Now here house was
recently broken into, Her car also broke down and she has
no money to pay for repairs. She feels like “bad things
keep happening to her.” She is having flashbacks , sleep
problems, and anxiety, and wondering if the problems will
ever end. She says she has always been the victim in life
and can’t handle it any more. She does consult with an
older woman friend for emotional support and also
periodically goes to “Victims of Crime” meetings in the
community. She mentors other young women who have
blamed themselves for being raped.
Things Will Change
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Planning for change vs. avoiding change
Inevitable and constant
Planting as seed in the client’s mind that things
always eventually turn around
Therapist amplify change
Looking For Exceptions
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Even in the stressor or presenting problem when
does it not occur?
Are there parts of the situation or reactions which
are useful?
No problem happens all the time.
Solutions are there already but just aren’t
implemented enough.
1) When you do not have the problem?
2) When the situation is “less bad?”
Looking For Exceptions
Insert Video
Planning Experiments and Tests
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We can plan for alternatives to the presenting
problem.
Therapist makes a suggestion of something to try.
Assignments outside the sessions used as adjuncts to
the session.
Planning Experiments and Tests
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Insert Video
There is some good even in what seems
bad.
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There are no problems... Only opportunities.
There are no failures.. Only learnings.
There are thousands of solutions.
There are no uncooperative people but only people
with unique ways of cooperating.
NO Real Resistance
Resistance
Persistence
There is some good even in what seems
bad.
Insert video.
Nothing stays awful forever.
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Give me the courage to change the things I can
change, the serenity to accept the things I cannot
change and the wisdom to know the difference.
Situation
What I Can’t Change
What I Can Change
Moving Away From “Why?”
What
How
• Do I do from here?
• Resources do I need?
• Will be different?
• Do I manage from here?
• I get to the desired
behavior?
Developing New Solution States
Visual
Kinsethetic
Auditory
Behavioral
Nothing stays awful forever.
Insert video.
You can do the right thing more/longer
until it is a habit.
Insert video.
MECSTAT
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Miracle Questions
Exception Questions
Coping Questions
Scaling Questions
Time Out
Accolades
Task
Miracle Questions
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A virtual reversal of the problem
Rehearsing the preferred future
If a miracle happened tonight what would be different?
What if your problems were solved just like that?
What was the most recent thing that was just like this
miracle?
0-10 miracle- don’t need to solve everything
Small miracles
Assumption: something happened and the problem is gone.
Co-constructing a new narrative with the therapist.
Miracle Questions
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Negotiated between the client and therapist
Deliberate wordsmithing
What speakers talk into being
A bringing forth of possibilities
Framing as a fresh start
Exercise: Miracle Questions
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Anger management
Unfaithfulness
Behavior Problems
Slacking/low motivation
Work run ins with the supervisor
Exception Questions
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When was the problem less severe?
What was happening?
When doesn’t the problem happen?
What would it take to recreate this?
What would you have to do to create more of this?
Idea of camera check or video showing something
Exercise: Exception Questions
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How would you handle these?
Drinking: “I’ve been drinking as long as I can remember.”
Anxiety: “I feel nervous and my heart races all the time.”
Relationships: “I am afraid my friend will leave me.”
Marriage: “We never have any trust.”
Job: “My boss is out to notice everything I do wrong. He is
waiting to fire me.”
Negative Expectation: “Life never goes my way. Nothing
works out for me.”
Coping Questions
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How did you manage?
What resources do you have?
How could you do that again?
What gets you through day to day?
What is your greatest support?
How did you get through that (in the past)?
Accomplishment Questions
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How did you do that?
How did you manage?
Helping to get the client to realize that someone
thing positive happened as a result of their actions.
Scaling Questions
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Determining where a goal is at on the scale now.
Moving increments of one point.
Scaling: preparedness for change, readiness for
new things, importance of a particular goal or
desired outcome
Things get better, stay the same or get worse- how
to frame for the client
Examples: Scaling Questions
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Different dimensions of a young ladies life
(Spiritual, intellectual, personal, etc.- what would
these look like and in relationship to each other.
Example: Framing if things got better
Example: Framing if things stayed the same
Goal Questions
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How will we know when therapy was successful?
How will we know when therapy should end?
Looking at what elements are necessary for
problem resolution.
Typical SFT Questions
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What are your hopes from our work together?
How will you/other know that having been here was
useful for you?
What would be the signs that you are better?
Supposing a miracle happened: what would be
different?
What would one step in the right direction look like?
Compliments or Praise
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How did you do that?
Most people ____ yet you managed ____. How
did you decide _______ instead?
To help give clients credit for their accomplishments,
good intentions or functioning.
Time Out
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Avoiding toxic behavior
Indirectly increasing the positive
Solution Focused Therapeutic
Conversations
Problem focus
Solution Focused
How long have you been
depressed?
What happens when you are
anxious?
When your relationship problems
are worse between you and your
parents how do you act?
Tell me about the nights when you
cry yourself to sleep.
Everywhere you go there seems
to be pain and grief.
What would it be like if you
were not depressed?
Accolades
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Compliments are important to producing change in
client.
Must be verbalized.
Looking for consistent positive feedback “in spite
of”
Examples: Accolades
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Insecure/no boundaries: Never could speak out
assertively and finely stated feelings
Not a risk taker and finely tried out for team, new
job, etc.
Task
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Concrete way of keeping what is productive or on
the path to the goal going
Homework is not best when created by the
therapist.
Emphasis on the client doing his/her work
First Session: between now and next time, we would
like you to observe so you can describe to us what
you would like to continue happening in your life.
Task
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Specific observations: Observe times between now
and next time when you and ____ could have done
(neg. behavior) and didn’t. Observe times where
(pos. behavior) occurred.
I am betting you won’t notice how things are.
Do one thing differently.
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Change on part of a problem: the timing, your body
patterns, what you say, where you act, the order
you do things in, the speed at which you do things,
etc. (e.g. Bill’s anger)
Think of something someone else does that works.
Focus on what you could concretely do instead of
what you feel.
Change what you are focusing on.
Do one thing differently.
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Imagine not having the problem.
Create a solution focused narrative. What were you
doing, focusing on?
Focus outside yourself on God, faith.
Act rather than analyzing the problem more. Use
solution focused words to affirm behaviors you want
(e.g. “I like it when….)
Exercise: Do something Differently
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What way can the person change his or her actions?
Bob is frustrated with his classmates. When he gets
answers wrong some classmates laugh at him and
talk about how stupid he is. He gives them dirty
looks back, screams, “Stop it! Stop it!” and cries. He
does not even want to go to school anymore at this
point .
Exercise: Do something Differently
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Mary hates going out in public because she feels on
the spot. She scopes out and notices all the people
she sees looking at her. Her heart races then and
she has often run out of social situations because of
it. She leaves groceries behind, misses numerous
appointments, and sees her family and friends less
often. She is becoming more home bound and
states, “this is the only place I am safe from
people’s opinions.”
Exercise: Do something Differently
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Andrew tries to ask a girl he likes for a date. It
takes him a lot of courage but when he asks her she
turns him down. He determines not to talk to people
again or take risks. He sits in the corner of the
lunchroom, refuses to talk to people and ignores
others’ attempts at conversation with him stating that
“he knows they will turn out bad too so why even
try.”
Exercise: Do something Differently
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Think of something else someone else does.
Todd gets angry when things don’t go his way. He
threatens people to make them do what he wants but
now he is finding out that many people are fed up and
just avoid him anymore.
Ann always sits in the corner of the room in college. He
prefers to not be noticed. When the professor asks her
something directly she wispers and talks very quietly
often hiding her face or looking down or away from
others.
Exercise: Do something Differently
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Dave determines that the only way out of his
trouble is suicide. More and more stresses pile up at
every turn. He thinks that just when he wants to
deal with one thing another comes. Since his life is
full of surprises and is much harder than anyone
else’s life he should just end it all. That is the only
way he believes he can have less stress in life.
Exercise: Do something Differently
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Focus on what you will concretely do instead of
what you feel.
“All eyes are on me,” says anxious Patty. “I know I
should not try new things because people will tell
how bad I am. I feel sure that they an all tell how
inexperienced I am and awful that I should not be
even trying out for the play.”
Exercise: Do something Differently
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Diane states , “I feel very self conscious. I do not like
the way I am. Wish I looked differently, had better
clothes, and didn’t seem so awkward to others. I always
feel on the spot.”
Jim feels doubtful about interviewing for another job
because when he interviews things usually do not come
through. It is not just jobs though but many businesses
he’s tried and relationships he sought out have had their
rough spots. Why try again? He reasons. It feels like
I’m up against a brick wall.
Exercise: Do something Differently
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Change what you are focusing on.
Lucy looks out at the crowds of people and scans
their faces before her speech. She studies the faces
closely and notices how many people appear to not
be exited about being there. She is sure they will
not be receptive to what she has to say.
Exercise: Do something Differently
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Daniel suffers from chronic pain. He states that his back
, spine and knees constantly give him trouble. He is
always aware of how his body is “falling apart” and
that he is not as young and vibrant as he used to be.
Amber looks out her window daily to see reminders of
living in a poverty stricken, unsafe neighborhood
because this is all she can afford now. She frequently
thinks about how she will never have anything better.
Exercise: Do something Differently
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Imagine not having the problem.
Amy has become increasingly depressed to where
she does not want to get out of bed, bathe or
attend to tasks of daily living. She no longer visits
neighbors. She eats less because even making food
takes too much energy. She stays in bed at least
12-16 hours per day to forget about life.
Exercise: Do something Differently
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Ramon is fearful about is job because the company is
unstable. Every day he waits to hear whether he is the
next one gone as the company is downsizing. He
believes it is just a matter of time before he is gone too.
Caroline is doubtful whether or not she will make any
real, long lasting friends since she has not connected
with anyone since moving from another town 3 months
ago. She feels out of place and is not sure that she will
ever have anything in common with the people from the
big city.
Changing Narratives
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What happens when others do not view the person
as mentally ill, crazy, incompetent, depressed etc.
Are there other people who managed through
similar situations?
Restorative narratives
Normalizing things people face
Changing Narratives
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Using the narrative to provide insight into self,
beliefs, values, goals
Identify choices.
Considering various endings to the story.
Changing Narratives
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Change these problem focused narratives to solution
focused narratives.
Bad things keep happening to me. Everywhere I turn
there is another issue to deal with. I slipped on the ice
one month ago and twisted my ankle. Now I got in a
car accident. I lost my job one week ago too. All there
is to do is sit at home and wait for the next bad thing
around the bend. Life doesn’t seem to work well for me.
Changing Narratives
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Once I was a young vibrant leader of the team. I was
so fit and able to do it all. But after my work accident I
can never hope to be the athlete I once was. The
physical therapy is challenging and reminds me of how
disabled I am. Going around my buddies and seeing
them throw the football in Jim’s yard while I sit at the
sidelines is degrading. I’ll only ever be the great
athlete of the past. I’m just a typical slowed down 50
year old like others who never were great athletes.
What was all my physical hard work even for!
Changing Narratives
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The flashbacks and nightmares will never stop. I
lived through a horror movie. My childhood was
one abuse by mom’s different boyfriends after
another. I see people so happy and trusting in
relationships but I know that can never be me.
People only hurt, betray, and cut down others.
There is nowhere to really feel safe. If you weren’t
safe in your own home how can you be safe
anywhere?
Focus on God or faith.
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You realize that stopping the alcohol abuse and
addiction is beyond you. Many generations of your
family have had alcohol problems. You can never
take just one drink because it always ends up in
binging, fights, and blackouts.
Focus on God or faith.
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Your moodswings make it hard to handle
interpersonal situations. It is challenging to be
flexible. Things get to you easily. You are helpless
to change unless you look outside yourself.
So many times you have said, “I feel awful. All can
see is anxiety and depression. Life is paralyzing
and immobilizing. When I look at myself I am
miserable.”
Focus on God or faith.
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Too many stressors seem to be happening at once.
It seems like it has been a long time since something
went well for you the way you think it does for
others. Two years ago there was someone thing you
worked hard at and waited on and had faith for.
Then one of your dreams came true.
Highlight what works well in words.
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Use language to highlight what you like: “I like it
when.”
In talks with my spouse I often do not feel like he
listens well. It seems like we talk two different
languages. But every now and then it seems like he
will understand what I am saying. He will pause,
stop what he is doing and look at me and really
hear me out.
Highlight what works well in words.
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Many times my teenage children seem to have minds of their own.
They don’t seem to care about my rules at all. They tell me they just
want to do their own things But the other day I had the surprise of
my life because they cleaned their rooms and talked very
respectfully to me and said, “Happy birthday, mom. We love you.”
The team at work I lead seems to be very inconsistent with their
productivity Some days it seems like they are slow and take all the
time in the world to even get started. But when the nice weather
started they worked harder and faster and got nearly double the
productivity so they could go home earlier. It helped the company.
Too bad they don’t have this work ethic on a regular basis.
The Language of Change
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Method/Technique: Therapeutic Dialogue
Questioning
Staging conversations:
1. Client concerns
2. Important topics
3. Exceptions and strengths
4. Resources available
5. Scaling to increase motivation for change
6. Scaling to reach the preferred future
The Language of Change
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Refer to the problem in past language: “was”,
“were”, “have been” versus “is” or “are”
Create expectancy- “when” versus “if”
Avoid yes and no questions. Invoke narrative.
Assume problem free times.
Use fast forward questions: who will notice
improvements? What will they say? How will they
respond? What will you be doing?
The Language of Change
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Small changes are emphasized
One ball or one layer at a time
Shift from impossible and what’s out of or hands to
what we can do
The ACCEPT Framework
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Acknowledge, validate, and value.- attending to
client’s perceptions, normalizing experience
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Clarifying concerns- discovering what would be a
successful outcome for the client
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Changing or challenging what is being attended to
and how it is done
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Evaluating progress- are the beliefs and actions
helpful?
The ACCEPT Framework
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Planning next steps- Set up experiments.
What is
progress? Try more of what works, less of what doesn’t
work. Modify as needed in small steps.
T
 erminating treatment- Once client is implementing
viable solutions and has understanding of the possibility,
solution focused applications allow them to take
responsibility for applying the framework in other
areas of their life
Link Past, Present, Future
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Past- strengths, abilities
Present- clients goals, desired outcomes
Future- Possibilities
Client Centered
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Therapist as facilitator
Clients set the goals
Clients shape how goals are defined
Clients shape what defines when goals are reached
(scaling)
Clients shape the success of counseling by their
narrative
About clients working through
THE CLIENT IS THE EXPERT !!!
Client Centered
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Clients should always be consulted regarding goals,
directions, and interventions of therapy.
Diagnosis, treatment, and notes are made available
readily to the client as a partner in determining the
course of therapy.
Simple, non clinical language is used.
The client’s language is used.
Clients are not passive people coming to an expert but
rather are active contributors in their own planning and
treatment.
Key Ingredients
Cooperative Therapeutic Alliance
 Warmth
 Positive Regard seeing the good in people
 Flexible to new ideas
 Listen for solutions in problem language
PROCESS VARIABLES

Still critical foundations for success
Empathy
Non possessive warmth
Genuineness

Whose are these? (Counselor Versus Client?)
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Hypothesis #1: Good counselors enhance treatment when
they have high levels of these variables.
Hypothesis #2: Clients determine the levels of variables.
Good clients elicit high variables but poor clients elicit low
variables.
NON-POSESSIVE WARMTH- mutual function
EMPATHY/GENUINENESS- under control of the therapist
The Person-Centered Approach
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(Original Outlook): Rogers- 1957
1. Two people in psychological contact
2. The client feels vulnerable or anxious about
something
3. The therapist is congruent and integrated
4. The therapist has unconditional positive regard for
the client.
5. The therapist shows an empathic understanding of
the client’s frame of reference.
6. The values listed above are communicated directly to
the client.
Defining Empathy
(Peterson, 2007; Miville, M.L., Carlozzi, A.F., Gushue, G.V., Schara, S.L., Ueda, M.,
2006; Vanearschot, G., 2007)


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1) A mode of experiencing the client
2) An ability to communicate this understanding
back to the client
3) Both affective and cognitive components
Three Types of Empathy
(Clark, A.J., 2010)



1. Subjective- momentary experiencing in session
what it may be like to be the client
2. Interpersonal empathy-Interpretation of the
client’s internal frame of reference
3. Objective empathy- the factual components of
behavior
Solution Focused Assessment

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Relabel what clients put in the past so as not to hinder
forward movement on goals:
“I’m so depressed all the time.”
“You have been depressed.”
Decrease the generalizability of the problem.
“I don’t recall when I’m not miserable. Everywhere life
is awful.”
“You have felt depressed much of the time lately.”
Solution Focused Assessment



Introduce a possibility mindset.
“I will never meet friends. They will abandon and
betray me too. How can I ever trust anyone?”
“You would like to consider getting into a safe
healthy new relationship.”
The Questions of Solution Focused
Assessment

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How will we know when it’s time to leave therapy?
When can we say that therapy is successful?
What kind of changes would you make?”
When were you pleased about how things were
going? What was happening?
What approach worked best for you?”
“What was your favorite _____ ?”
The Questions of Solution Focused
Assessment

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
How will we know therapy has been successful?
Who decided that this treatment was good for you?
What shows that this is the best way for you to solve
things?
What will others see when you are better?
How would you deal with ____ if things were
better?”
The Questions of Solution Focused
Assessment

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What meds, therapies, decisions, actions, etc.
worked best for you?
What has been most valuable to you?
What would a future free of this problem look like?
What is going well? How could we use that to our
advantage?
Listening To The Client

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Honor the clients story.
Be willing to do nothing.
Sit with the client.
Resist the urge to fix.
Give credit for small efforts.
Key Ingredients
Solution Focus
 There is something you do well. You just don’t know
it.
 Recollecting what works.
 Creating insight and understanding of what is useful
and advantageous for this client, this situation, this
setting, etc.
Key Ingredients





Answers are within the clients.
Clients generally know what to do . They just don’t
do it enough.
Clients have strengths in the midst of perceived
weaknesses.
Breaking down the problem past is not useful to
recovery and goal attainment.
Diagnosis should not be the emphasis.
Key Ingredients
Measurable Behavioral Goals
 How can I be useful to you?
 What would others notice if therapy worked fro you?
 How would we know therapy did what it was supposed to
do?
 What needs to be different for your life to be as you’d like
it?
 Multiple simultaneous goals
 Describe production action rather than absence of action
 Realistic and achievable
Key Ingredients

All behaviors have contexts.
Individual
Other
Context
Socio-cultural
Interpersonal
Key Ingredients
Measurable Behavioral Goals
 Actions are changeable.
 Actions do not need to be changed all at once.
 Small steps can caused positive chain reactions in
other areas.
 Emphasize why the problem is not worse.
 Talk a lot about what happens when things work.
Key Ingredients
Client Evaluation (Through Scaling)
 Putting a 1-10 number on motivation, preparedness,
importance of goal, progress
Areas That Can Be Changed

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Location
Timing
Frequency
Interactions
Antecedents
Duration
Nonverbals
Sequences of actions
Attention
Reactions
Facilitating Solutions

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
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Previous solutions
Exceptions
Competencies
Goals, hopes
Possibilities
Action Plans
SMART
Small
Measurable
Achievable
Realistic
Timeline
Exercise: Concrete, Behavioral SolutionFocused Goals
Stated Goal
To feel less depressed
To be more confident and assertive
To not be so fearful in new situations
To have a better relationship with my child
To improve the quality of my marriage
To be more motivated in school
To take care of myself better
New Concrete, Behavioral
Goal
The Language of Solution



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
1. exceptions to the rule (e.g when you weren’t
hopeless or acted in spite of panic)
2. the end game- thinking about what life will be like
when the problem has ended
3.highlighting choice- there are always a variety of
reactions
4. find contexts of competence (if you face this.. how
to handle)
5. worst case comparison- why not worse?
6. tapping into altruistic experience- how you learned
and applied something to help others with similar issues
Types of Scaling

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
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Willing to change scaling
Confidence in change scaling
Relationship scaling
Behavioral outcomes scaling
Key Ingredients
An active approach by setting up situations outside
therapy
 What do you like about yourself?
 What are 2 things to try?
 What are some things that happened right?
 What would hope look like?
Examples of Thoughts Provoking
Considerations For Clients

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

Who I can trust
Who I can share my story with
Who helps me be less depressed, anxious, etc.
Who can get me the resources or support I am
looking for
Who will leave me alone unless I need them
Who/what promotes hope
What helps me regain control in my life
Key Ingredients
Compliments
 Validating is a key element.
 Building therapeutic alliance
 Building client competency
 In midst of genuine supportive relationship
 Affirmation needs to be verbal in the therapeutic
process.
 Affirmation needs to be specific and behavioral.
Key Ingredients

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Do something different.
Don’t continue what does not work.
This may include switching therapist and techniques
Change goals.
Change anything!!! Disrupting the system often
creates positive
Termination in Solution Focused
Counseling


How will we know we have reached goals?
How do we know when to stop meeting like this?
Solution Focused Groups



Change is constant.
Change is inevitable.
The group dynamics embody the changes of the
individuals in time
Comparison of Traditional and
Solution-Focused Therapies
Traditional Counseling
Solution Focused Counseling
Impairments, deficits
Competence, abilities, possibilities
Pathology
Health
Resistance, defenses, hidden agendas
Good intentions, cooperation
Cure
Consultation, small changes
Therapist as expert
Therapy is collaborative, shared
experience, client is expert
Comparison of Traditional and
Solution-Focused Therapies
Traditional Counseling
Solution Focused Counseling
Working through, insight
Goals, behaviors, results
Past
Present, future
Expression of emotion
Validation of experience
Diagnosis
Change orientation
Problem identity, character, personality
Productive action, process
Couples SFT

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Talk about what works.
Avoid blame.
Use I messages to summarize and empathize with
each other.
Use action requests.
Affirm helpful behaviors.
Change only your part.
If things aren’t working change it. Don’t repeat the
same things which don’t work.
Drug and Alcohol Treatment

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
De- emphasize labels of alcoholic and addict
Focus on personal choices.
Look at interpersonal dynamics which contribute to
denial and resistance.
Acknowledge client concerns.
Encourage alternative behaviors.
Disease concept is not helpful- maintains problem
focus, not truth.
Chronically Mentally Ill Patients

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Don’t get hung up on diagnosis.
Relate to the client.
Help them deal with misperceptions by others and self
critical attitudes.
Be flexible to learn from the client.
Just because something seems chronic does not mean it
cannot change (e. 50-60% of schizophrenics
significantly improve as they get older and learn to
manage symptoms better)
Support client goals
Reward small incremental goals rather than cures.
Career Counseling With SBT
Burwell, R., & Chen, C.P. , 2006

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Strong collaborative working alliance
Therapist is curious and unknowing, being taught by
client
Looking at accessible resources rather than
analyzing problems
Developing viable vision and alternatives which
promote hope
Finding alternative solutions with the last option
being changing work environment
Career Counseling With SBT
Burwell, R., & Chen, C.P. , 2006
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Don’t fix what is going well.
Change what is not working.
When is the problem not co-occuring?
Goal oriented: multiple solutions, collaborative
constructing of problems and solutions
Scaling- what would be the next step
Normalizing problems
Restructuring problems in context
Affirming efforts in spite of problems
Career Counseling With SBT


When the problem was not there or was less of an
issue what behavior choices were going on?
Imagining self five years for now without the
problem. What needs to happen?
Educational Settings and SFT
Simm,J.,& Ingram, R., 2008

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

Do problem solving with students using students own
ideas
Educational staff using solution focused approaches
in meetings
Using solution focused approaches for behavior
plans and IEPs
Using solution focused approaches in peer supports
Educational Settings and SFT
Simm,J.,& Ingram, R., 2008
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Concentrating on solutions
Felt like a relief
More do-able
More successful because based on students or staff’s own
ideas
Empowering
Not trying to impose something from without
Not an assumption of teachers or administration being the
experts
Within 20 minutes or less saw results from difficult students
Efficient problem solving
Reducing Truancy Through SFT
Enea, V., & Dafinoiu, I, 2009
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61% compared to 0% on control group
Behavioral programs imposed from without
generally did not work
Motivational interviewing and SFT did well with
truant kids
Stimulated intrinsic motivation
Focus on pros and cons of truancy, development of
trust, building strengths and resources, brainstorming
and reframing, negotiating change
Reducing Truancy Through SFT
Enea, V., & Dafinoiu, I, 2009

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Imaging truancy not being a big issue
Reflecting on times when this happened
Affirming efforts and successes at getting up,
getting to school on time, etc.
Scaling
Supports need to lessen truancy
Options to typical truancy behaviors- eating out,
walks, meeting up with friends, smoking/drugs, etc.
Domestic Violence Therapy Using SFT
Milner, J., & Singleton, T., 2008

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No single factor predicts re-offense
Hearing client’s unique stories
Client responsibility for development of new
behaviors
Consideration of exceptions to the problems that
got them in trouble
Framing in terms of choices and options
Learning to monitor risk and use scaling
Sexual Abuse Survivors and SFT
Kress, V.E., & Hoffman, R.M., 2008

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
Shift from self as blame to alternative possibilities
Therapeutic stories
Letter writing to those who have gone through
similar things- providing wisdom and support
New symbols and representations of overcoming
Management of strong feelings
Increased self confidence
Sexual Abuse Survivors and SFT
Kress, V.E., & Hoffman, R.M., 2008
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Improved self esteem
Decreased isolation
Better interpersonal connectedness
Awareness of strengths they did perceive before
Increased future orientation
Examples: The Girl Who Didn’t Treat Herself Well,
The Caterpillar
The Girl Who Didn’t Treat Herself Well
Once upon a time there was a very kind and caring girl who was
kind to everyone she met. She was kind to her friends, her teacher,
and her neighbors. Because she was so kind, friendly, and
agreeable, pretty much everyone liked her.
However the girl who was so nice to others was not so nice to
herself. She did many things to herself that were not so nice. She
would smoke, she did not sleep well, have fun doing things she
enjoyed, didn’t keep safe, didn’t have a sense of humor and have
fun, didn’t think about the future, ate unhealthy foods and never
exercised. Because neglect can make a heart sad, her heart
became very sad. “You are nice to everyone but me, cried the
girl’s heart. But she continued to ignore it because she thought that
everyone else was more important than she was, and she believed
it was selfish to take care of her own heart.
The Girl Who Didn’t Treat Herself Well
So her heart continued to cry. The tears got so hard that
they clogged up her heart. When this happened, the girl
felt pains in her chest and all over her body. “You have
been ignoring me as I’ve cried for you to be nice to me, so
I am going to give you a pain that you won’t be able to
ignore---- you need to pay proper attention to me---help
me!” Her heart was right about that! The pain felt so bad
that she decided to go to the hospital. The doctors took
pictures of her heart and found that the tears had become
so hard that they clogged up her arteries leading to her
heart.
The Girl Who Didn’t Treat Herself Well
“We’ve got to fix your heart,” the doctors told her. “We are
going to take you to surgery to repair the damage.” So that is
just what they did.
As she recovered for her surgery the doctors came to talk to
the girl. “We have heard that you are nice to everyone but
we have discovered that you are not nice to yourself. From
now on, you must be nice to yourself. You have to eat healthy
foods and get enough sleep, think positively, plan your future,
exercise, talk to your friends, be with safe people, and not
smoke or do drugs. If you can learn to love your body and be
nice to yourself in these ways, the pain in your heart will go
away. Then your heart can be filled with love for yourself as
well as for others- and you will be way happier!”
The Girl Who Didn’t Treat Herself Well
Because the girl was smart and because her heart had
taught her a valuable lesson, she found ways to be nice to
herself. She learned to think positive plan her future,
sleep well, eat right and exercise, and do lots of really
caring and safe things. She learned that the more safe
and healthy things she did for herself the better she felt.
She was soon able to be as good to herself as she was to
others. And from that time on, her heart began to smile.
The girl learned that having a heart filled with love means
not only loving others but also loving yourself.
The Caterpillar
Once upon a time there was a caterpillar named Anna. Anna thought,
“I am not colorful like birds. I do not flutter, fly, or pollinate flowers like
butterflies. I don’t make beautiful noises like crickets. I’m really
different.”
As the caterpillar grew, she noticed that children were even afraid of
her. Some children would occasionally say ”ewwwww” or “yuck” when
they saw her. Even when they didn’t say anything mean, she thought
that they were thinking they did not like her. She wondered why she
couldn’t be like the others- the birds, or the crickets, or even the soft
and fuzzy squirrels. She thought those other creatures must be so much
happier than she. All she knew was that she felt ugly.
The Caterpillar
Mostly though, she just didn’t think anyone noticed her or cared about
her. With all these sad thoughts, it’s no wonder Anna felt bad and sad.
“Why did this happen to me?” she would cry… why can’t I be a
beautiful bird? No one else knows how it feels to be me…why? Why?
Why? My destiny is to be ugly and to repulse others.”
She was afraid to tell others how hurt and sad she felt. One she tried
to tell someone how she felt, and they ignored her; and this hurt even
worse. She thought, that’s it. I can’t trust people and I can’t trust what I
think and feel either. I am just an ugly caterpillar.” So Anna went on…
fighting with herself and fighting against the world and how she
thought everyone saw her.
The Caterpillar
She met several other caterpillars- they all quickly became friends.
Anna somehow mustered up the courage to tell the other caterpillars
how she felt. They chuckled to themselves and told her that she was
beautiful inside and someday she would realize this beauty. “Deep
inside,” they said, “you are a beautiful butterfly! She thought…”yeah
right… I’m beautiful? Come on. They’re just saying that. I’m not
beautiful on the inside or on the outside!”
The caterpillars told her that in order to become a butterfly she’d need
to look inside for the beauty and the strength….that they could talk
with her and support her but she had to believe in herself and have
faith., and only then she could do what was necessary to change into a
beautiful butterfly.
The Caterpillar
Anna thought this was a hopeless and very silly thing to do. She
thought this was fine for her friends but that she was different. She was
more ugly and way worse off than them. “Even though my friends are
caterpillars, “she said, “I’m different and more hopeless than them.”
So she sat…and sat,,,and sat…and watched her friends turn into
butterflies and fly away. One day she became sick and tired of sitting.
That’s it, she said. I’m going to really try to believe I’m beautiful. I’m
going to think positive thoughts and I’m going to feel better…even if a
little part of me is afraid to do that. I’m going to really look inside
myself for my beauty. I’m not going to fight myself any more.
The Caterpillar
And then… she put her energy into trying to find the beauty, and thinking
positively and trying to be happy. It was so hard though; she had to be very
patient and that was really frustrating!
But she tried and tried and tried and tried to see her beauty.
As she tried she noticed and began to develop a warm, safe cocoon around
her little caterpillar body. It just sprang up! It felt a little scary and weird but
a little nice also! She wanted to fight it but she didn’t fight it…she embraced
it. But eventually the cocoon started to feel very comfortable and safe.
And then one day she emerged from her cocoon a beautiful butterfly!
The Caterpillar
“You were always beautiful,” said one of the
caterpillars. “You had to put your energy into
believing and look what you’ve become.” As the
butterfly thought about what had happened she
realized that her beauty was buried inside her just
waiting to be unleashed and that others could see it in
there but she couldn’t.
Couples Therapy and SFT





Couples can build on successes in spite of perceived
problems
New healthy observable, measurable, achievable
goals can be worked on in small steps
We can find exceptions to the problem.
Couples can actively seek and look for change.
Learning to discover a window on your spouse’s
world.
Couples Therapy and SFT






Teach couples how to use solution focused language
with each another:
“What was useful about this?”
“What tells you we are at a ____ (#)?
What would people notice first if we changed that
way?
How does that help you?
What would be useful right now?
Solution Focused Groups








4-6 sessions
Time limited
Very focused and goal directed action
Transition away from problem language to strengths
based language
Building on the multitude of examples in group
Help overcome stuckness
Empower group members
Help people learn new skills and redefine problems
Solution Focused Groups



Improved overall well being
New options and opportunities
Address universal goal of a happier life
Spiritualty Based Clients



Revisit spiritual moments and times.
Recreate helpful spiritual experiences.
Increase the frequency of what worked. Bring those
past experiences into the present.
Solution Focused Supervision
McCurdy, K., 2006





Collaboration between supervisor and supervisees
Process variables highlighted
Allows for imperfections in counselors
Concentrating on what the supervisee is doing
rather than what he or she is not doing
Emphasizing on present performance rather than
past failures
Solution Focused Supervision
McCurdy, K., 2006








Rewarding effort rather than outcome
Mistakes seen as learning experiences
Allowing supervisees to role model and teach others
Referring clients to supervisees
Inquiring about the supervisees perspective- “What do
you think is the most important part of this counseling or
supervision relationship?”
Acting as if improvements happened
Use of scaling (1-10)
Noting exceptions to stuckness with clients
Bibliography






Burwell, R., & Chen, C.P. (June 2006). Applying the principles and techniques
of solution-focused therapy to career counselling. Counselling Psychology
Quarterly, 19(2), 189-203.
Enea, V., & Dafinoiu, I. (September 2009). Motivational solution focused
intervention for reducing school truancy among adolescents. Journal of
Cognitive and Behavioral Psychotherapies, 9(2), 185-198.
Kress, V.E., & Hoffman, R.M. (2008). Empowering adolesent survivors or sexual
abuse: application of a solution-focused Erickson counseling group. Journal of
Humanistic counseling, Education, and deelpoment,47, 172-186.
McCurdy, K.G. (Summer 2006). Adlerian supervision: A new perspective with a
solution focus. The Journal of Individual Psychology, 62(2), 141-153.
Miller, J.H. (September 2010). Does teaching a solution-focused model of
counselling work? A follow up of graduates. Counseling and Psychotherapy
Research, 10(3), 173-182.
Milner, J., & Singleton, T. (2008). Domestic violence: Solution-focused practice
with men and women who are violent. Journal of Family Therapy, 30, 29-53.
Bibliography
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Peacock, F. (2000). Water the flowers, not the weeds.
Montreal: Open Heart Publishing.
Simm, J., & Kendal, R. (March 2008). Collaborative action
research to develop the use of solution-focused approaches.
Educational Psychology in Practice, 24(1), 43-53.
Strong, T., & Pyle, N.R. (2009). Constructing a
conversational “miracle”: Examining the “miracle question”
as it is used in therapeutic dialogue. Journal of Constructivist
Psychology, 22, 328-353.
Wilson, M. & Turneil, A. (1993. Introduction to Solution
Focused Brief Therapy. Centrecare Brief Therapy Service.